To evaluate the safety and efficacy of laparoscopy combined with choledochoscopy in the treatment of hepatolithiasis complicated with choledocholithiasis.

Clinical data of 32 patients with hepatolithiasis complicated with choledocholithiasis who underwent laparoscopic hepatectomy combined with choledochoscopy in Shanghai Pudong Hospital Affiliated to Fudan University from January 2014 to December 2018 were retrospectively analyzed. Among them, 13 patients were male and 19 female, aged from 32 to 84 years with a median age of 59 years. The informed consents of all patients were obtained and the local ethical committee approval was received. The intraoperative conditions and postoperative recovery of the patients were observed.

29 patients completed laparoscopic surgery while 3 cases were converted to open surgery. Among them, 27 cases underwent the left lateral hepatectomy and 5 left hemi-hepatectomy. 18 patients underwent choledocholithotomy and the placement of T tube, and 14 cholangioscopic lithotomy. The average operation time was (221±41) min, and the intraoperative blood loss was (260±62) ml. The postoperative anal exhaust time was (42±17) h, and the length of postoperative hospital stay was (10±2) d. Postoperative hemorrhage occurred in 3 cases, which were treated with blood transfusion and administration of hemostatic drugs. Postoperative bile leakage was observed in 3 cases, which were healed after drainage for 10 d. No other complications, such as abdominal infection, were noted. Postoperative residual choledocholithiasis occurred in 2 cases, which were removed by cholangioscopic lithotomy through the T tube sinus tract.

Laparoscopy combined with choledochoscopy is safe and efficacious in the treatment of hepatolithiasis complicated with choledocholithiasis.